1011例食管/贲门双原发癌(双源癌)患者的家族史、临床病理及生存期分析

目的分析比较食管/贲门双源癌和单发食管/贲门癌患者的家族史、临床病理及生存期的关系。方法采用家访和问卷调查、住院病理核查以及电话随访等方法,收集整理河南、河北、山西三省交界食管癌高发区的1 011例双源癌患者、2 095例单发食管癌患者和1 859例单发贲门癌患者的家族史、临床病理资料和部分随访结果。采用SPSS 17.0统计学软件进行统计,t检验、χ2检验、Kaplan-Meier生存分析及多因素Cox模型等方法分析双源癌和单发食管/贲门癌患者家族史、临床病理和生存期的关系。结果双源癌家族史阳性率比单发贲门癌家族史阳性率高(34%,27%,P<0.05),与单发食管癌相似(34%,31%,P<0.05);双源癌中食管癌和贲门癌早期患者多于单发食管癌(27%,15%)和单发贲门癌患者(18%,4%,P<0.05);双源癌患者生存率低于单发食管癌和单发贲门癌患者(P<0.05),死亡风险分别为单发食管癌和单发贲门癌患者的2倍(P<0.05,HR=1.976)和3倍(P<0.05,HR=2.652)。结论双源癌患者遗传易感性高于单发贲门癌患者;双源癌中食管癌和贲门癌早期患者均多于单发食管癌和单发贲门癌患者;双源癌患者生存率低于单发食管和贲门癌患者。

Analysis on family history,cinical pathology and survival for the patients with concurrent esophageal and gastric cardia cancers(n=1011)

Objective To compare the family history,clinical pathology and survival rate on the patients with concurrent esophageal squamous cell carcinoma(SCC) and gastric cardia adenocarcinoma(GCA)(CC patients) and the patients with either single SCC or GCA.Methods Home visit,questionnaire survey,hospital pathological check and telephone follow-up were performed in 1 011 patients with CC,2 095 patients with single SCC and 1 859 patients with single GCA.These patients came from the high incidence area of SCC and GCA at the junction of Henan,Hebei and Shanxi Provinces.SPSS 17.0 statistical software was used for,t-test,chi-square test,Kaplan-Meier survival analysis,Cox-regression model was used to analyze the relationship of family history,clinical pathology and survival rate between CC patients and single SCC or GCA patients.Results The positive family history rate of patients with CC was higher than those with single GCA(34%,27%,P<0.05),but similar with that in the single SCC patients(34%,31%,P<0.05).The early SCC and GCA from CC was more common in those with single SCC(27%∶15%) and GCA(18%,4%,P<0.05).The patients with CC had shorter survival time than those with single SCC and GCA(P<0.05),the mortality risk for CC was 2 folds and 3 folds higher than in those with single SCC(P<0.05,HR=1.976) and GCA patients(P<0.05,HR=2.652).Conclusion The hereditary susceptibility of CC patients is higher than the single SCC/GCA patients.The CC patients have shorter survival time than those with single SCC/GCA.